Nitrazepam

[oceanred]

To help me sleep occasionally, I take half a Nitrazepam 5mg tablet about every 7-10 days, which has been effective up to now. I am reading on here that dopamine agents can make RLS worse over time. Is it safe to moderate it like I do (i.e. about half a tablet every 7-10 days) without getting any adverse side-effects in the long run? As a rule, I try and avoid taking these sleeping tablets unless I have had two really bad night's sleep in a row.

[Hidden]

It's not a good idea to take RLS meds unless your RLS is severe.

You should consider other options first.

One source I've read says for intermittent RLS, i.e only requiring medication about once a week, L dopa is an option, a benzodiazepine or a weak opiood.

Iron therapy is the first treatment that should be tried for RLS. This involves having blood tests for serum iron, transferrin saturation and ferritin.

If your ferritin is less than 75, an oral iron supplement may help. If it's over 75 then an IV iron infusion will be better.

Another thing you could do is to identify any aggravating factors making your RLS worse and avoid or correct them.

This could include any one of many drugs, diet, exercise and anxiety.

Supplements for vitamin B12, vitamin D. magnesium and an antioxidant may help.

In answer to your question , I'd say taking a dopamine agonist (DA) is the worst possible option. DAs are no longer recommended as the first treatment for RLS.

Pregabalin or gabapentin are.

See this link

mayoclinicproceedings.org/a...

[oceanred]

Thanks. I think Nitrazepam is a benzodiazepine, so according to the linked article, it is ok for intermittent RLS.

[Hidden in reply to oceanred]

Yes that's correct, nitrazepam is a benzo.

I'm not sure if it makes a lot of difference but the usual one for RLS is clonazepam.

[Jumpey]

Years ago when my RLS was mild I used to take diazepam in a similar way to you with no adverse effects. As Manerva suggests I would check your ferritin levels and you may find iron therapy erradicates your symptoms. Good luck.x

[oceanred]

I had my blood levels checked a month ago - hb 108 and ferritin 5, so I got an iron infusion. Ferritin is now 363 and hb is still low at 120. GP says it takes a while for iron to even out in the body, so even though my ferritin is now high, it might not take effect for up to 3 months.

[Hidden]

Your iron situation isn't straightforward.

When it comes to iron, the body gives preference to the blood. You can for example survive there being some iron deficiency in the brain, but iron deficiceny anaemia (IDA) is a different matter.

The more severe IDA is the less oxygen the blood can carry and if it is severe enough then it can be life threatening. You cannot do without oxygen, Try holding your breath

Ferritin is "stored" iron and although your ferritin is currently high, it will go down. The stored iron will be used to correct your IDA.

Only after the IDA is corrected will a high ferritin even begin to rectify Brain Iron Deficiency.

In simple terms then, iron therapy is not going to be very effective for RLS until your anaemia is corrected.

[oceanred in reply to Hidden]

Thanks. I will speak to my GP again on Monday to see if I should be taking iron tablets again. It's confusing because my ferritin is high but my hb is low.

[Hidden in reply to oceanred]

Yes it is confusing.

Be aware that if your GP isn't knowledgeable about RLS, not unusual, then the relationship between haemoglobin, ferritin and brain iron deficiency may not occur to them.

All you need from your GP is to know it's safe for you to take iron.

If it's ok, you don't their permission and you don't need a prescription.

Read other posts on what's the best supplement and how to take it.